Occurrence Of Inguinal Hernia Research Articles

A novel anterior approach that involves Retzius space development between the umbilical ligaments is associated with a lower incidence of postoperative inguinal hernia in robotic radical prostatectomy

BackgroundTo facilitate robotic radical prostatectomy (RP), we developed a novel anterior approach that utilizes a peritoneal incision between the umbilical ligaments to develop the Retzius space without contacting the internal inguinal rings, followed by closure of this space prior to prostatectomy and vesicourethral anastomosis. This approach could decrease the incidence of postoperative inguinal hernia (IH), similar to a Retzius-sparing RP (RS-RP). We compared the incidence of IH following this novel approach with that following conventional anterior RP and RS-RP. MethodsWe retrospectively reviewed 532 patients who underwent robotic RP from September 2017 to August 2022. We compared the incidence of IH following novel anterior RP (n = 153) to that following conventional anterior RP (n = 284) and RS-RP (n = 95). We also assessed the independent factors associated with postoperative IH using Cox hazard models. ResultsThe 12- and 24-month cumulative incidences of postoperative IH following novel anterior RP were 1.3% and 1.3%, significantly lower than those associated with conventional anterior RP (8.0% and 12.6%, p = 0.009) but not significantly different from those following RS-RP (1.1% and 2.1%, p = 0.782). In multivariate analysis, use of the novel anterior RP approach, RS-RP, and body mass index were independent factors negatively associated with the occurrence of postoperative IH. ConclusionsThis novel anterior approach involves developing the Retzius space between the umbilical ligaments and closure of this space following prostatectomy and vesicourethral anastomosis. It can decrease the incidence of IH compared to the conventional anterior approach. Prospective comparative studies are necessary to confirm the benefits of this approach.

Altered Transcript Levels of MMP13 and VIT Genes in the Muscle and Connective Tissue of Pigs with Umbilical Hernia.

Umbilical hernia (UH) and inguinal hernia (IH) are among the most common defects in pigs, affecting their welfare and resulting in economic losses. In this study, we aimed to verify the association of previously reported differences in transcript levels of the ACAN, COL6A5, MMP13, and VIT genes with the occurrence of UH and IH. We examined mRNA levels in muscle and connective tissue from 68 animals-34 affected by UH and 34 controls. In a second cohort, we examined inguinal channel samples from 46 pigs (in four groups). We determined DNA methylation levels in muscle tissue for the UH and control animals. The transcript level of MMP13 changed in the UH cases, being upregulated and downregulated in muscle and connective tissue, respectively, and the VIT gene also showed an increased muscular mRNA level. The transcript of the ACAN gene significantly decreased in old pigs with IH. We further observed an increased DNA methylation level for one CpG site within the MMP13 gene in UH individuals. We conclude that these alterations in gene mRNA levels in the UH animals depend on the tissue and can sometimes be a consequence of, not a cause of, the affected phenotype.

Laparoscopic Inguinal Hernia Repair and Synchronous Peritoneal Dialysis Catheter Placement: A Single-Center Experience.

Background: Peritoneal dialysis (PD) is a common method for treating end-stage renal disease (ESRD). Occurrence of inguinal hernia before and during PD is considered to be the main cause of treatment discontinuation, failure, and conversion to hemodialysis. In this study, we present a single-center experience about laparoscopic inguinal hernia repair and synchronous PD catheter placement and evaluated the feasibility and outcomes. Methods: During May 2018 to May 2022, a total of 216 consecutive patients with ESRD underwent laparoscopic PD catheter placement. Among them, 41 patients (27.7%) with coexistent inguinal hernia were included in this study. Individual information, complications, recurrent and new-onset hernias, and catheter survival were retrospectively analyzed. Results: Forty-one patients underwent laparoscopic inguinal hernia repair and synchronous PD catheter placement, 9 patients had bilateral inguinal hernia, and another 32 patients had unilateral inguinal hernia. The mean age was 46.49 years (range, 28-72 years), including 39 males and 2 females. There was no recurrent hernia and only 1 patient (2.4%) developed incisional hernia (trocar site hernia) which required hernia repair and discontinuation of PD. No postoperative complications were observed, such as bleeding, infection, and dialysate leakage. After a median follow-up of 37 months (20-58 months), there were no deaths and 97.6% (40/41) catheters were still working. Conclusions: Laparoscopic hernia repair and synchronous PD catheter placement is an effective and safe treatment for ESRD patients with coexisting inguinal hernia in virtue of low postoperative complications and high catheter survival.

Long-term results after robot-assisted radical prostatectomy of a simplified inguinal hernia prevention technique without artificial substance use.

Durable techniques that prevent postoperative inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) have not been established. This study evaluated the long-term efficacy of a postoperative IH prevention technique that uses no artificial agents to assess the characteristics of IH occurrence after introducing this technique. We retrospectively analyzed 201 consecutive patients who underwent RARP at our institution between September 2011 and February 2014. In total, 189 cases were eligible for the study. The non-IH prevention and IH prevention groups comprised 72 and 117 cases, respectively. We compared the incidence of IH between the two groups using Kaplan-Meier curves. Risk factors for IH in the prevention group were determined via multivariable logistic regression analysis. The rate of IH occurrence was 20.8% (15 cases) in the nonprevention group and 8.5% (10 cases) in the prevention group, with median follow-up periods of 99.5 and 89.9 months, respectively. The Kaplan-Meier curves indicated a significant difference between the two groups (p = 0.011). Only cutting of the vas deferens significantly contributed to reduced occurrence of IH in multivariable analysis (p = 0.047). After reviewing the intraoperative videos, insufficient separation of the vas deferens was considered the main cause of IH in the prevention group. Our simple prevention technique with no artificial agents had a durable effect on IH prevention after RARP over a median follow-up period of more than 7 years. Cutting the vas deferens effectively prevented IH after RARP.

Laparoscopic surgery: an effective and safe surgical method of pediatric inguinal hernia repair.

PurposeInguinal hernia (IH) repair is very commonly performed in children. While open repair (OR) is the standard approach, laparoscopic repair is increasingly used. This study was aimed to investigate safety and feasibility of laparoscopic repair of pediatric IH compared to OR.MethodsWe retrospectively enrolled 105 pediatric patients with IH repair between January 2011 and October 2019. The laparoscopic procedures performed were laparoscopic percutaneous extraperitoneal closure (LPEC), and three-port mini-laparoscopic repair (TLR). The OR was performed as per usual technique.ResultsThirty-nine patients underwent OR, 16 LPEC, and 50 TLR. The preoperative laterality of IH was 45 patients (42.9%) on the right side, 50 (47.6%) on the left side, and 10 (9.5%) on both sides. It was, however, diagnosed postoperatively in 27 patients (25.7%) on the right side, 38 (36.2%) on the left side, and 40 (38.1%) on both sides. Of the 63 patients who presented with unilateral IH in the laparoscopic groups, 32 (50.8%) had synchronous contralateral patent process vaginalis (PPV) which were simultaneously repaired. This was significantly more common in children under 3 years of age. Operative time in unilateral or bilateral repair was significantly shorter in the laparoscopic repair groups (p < 0.001). Ipsilateral recurrence was not observed in any group. Metachronous contralateral IH occurrence was not significantly different between groups.ConclusionLaparoscopic IH repair may have benefit in terms of shorter operation time and diagnosis of unpredicted contralateral PPV compared to OR.

\u201cLocus minoris resistentiae\u201d and connective tissue weakness in older women: a case report and literature review on pelvic organ prolapse with inguinal bladder hernia

BackgroundConditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling.Case presentationThree cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general.ConclusionThe simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a “locus minoris resistentiae”. Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients’ compliance with further surgical treatment for hernia.

Comparison of Incidence of Inguinal Hernia among Obese and Normal Individuals: A Retrospective Analysis

Objective: The objective of the present study was to verify whether obesity is associated with the occurrence of inguinal hernia.&#x0D; This is a cross-sectional study carried out in a tertiary hospital, including 84 patients, with clinical diagnosis of inguinal hernia, who underwent hernia mesh repair during a 6-month period (January 2021 to June 2021). Demographic, anthropometric and diagnostic data for inguinal hernia were taken from the patients' medical records.&#x0D; The Chi-square test was used to calculate the significance of association.&#x0D; Results: A total of 84 patients were included in this study. The age of patients varied between 39 - 75 years, averaging 54.8 years.&#x0D; The study showed an association between BMI and two factors, namely: Age (P = .023) and size of the defect (P = .005). However, hernia type (P = .797) and its content (P = 0.061) did not show such an association.&#x0D; Conclusion: In conclusion, these results may be a useful guide for future studies about the relationship between BMI and hernia and may provide foundation for better understanding of the pathophysiology of hernia is obese.

Matrix Metalloproteinases (MMP-2) and Tissue Inhibitors of Metalloproteinases (TIMP-2) in Male Inguinal Hernia Patients at Different Ages.

Collagen metabolism, controlled by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), might be related to inguinal hernia formation. It was reported that the incidence of inguinal hernia and the recurrence rate after inguinal hernia repair were higher in the elderly. The objective of the research was to assess the amounts of MMP-2 and TIMP-2 in patients at different ages in order to examine the relationship between age and inguinal hernia occurrence. The research included 40 primary inguinal hernia male patients, and four groups were created: 50-59years old (A group); 60-69years old (B group); 70-79years old (C group); 80-89years old (D group). We got the samples from anterior rectus sheath fascia. Real-time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry were applied to estimate the levels of MMP-2 and TIMP-2. The MMP-2 amounts in C and D group were statistically higher than control group (P < 0.05), and the TIMP-2 levels in C and D group were statistically lower than control group (P < 0.05). We found a positive correlation between age and expression levels of MMP-2 (r = 0.537, P < 0.001; r = 0.569, P < 0.001) and a negative correlation between age and TIMP-2 in inguinal hernia patients (r = - 0.759, P < 0.001; r = - 0.759, P < 0.001). Increased MMP-2 and reduced TIMP-2 may have some relationships with higher inguinal hernia incidence of the elderly.

Robot-assisted radical prostatectomy may induce inguinal hernia within the first 2 years

At present, robot-assisted radical prostatectomy (RARP) is a gold standard in radical prostatectomy. The aim of this study was to evaluate the incidence, risk factors, and timing of occurrence of inguinal hernia (IH) after RARP.We included 427 patients with prostate cancer who underwent RARP by a single surgeon from February 2006 to August 2017. Incidence, clinical, and pathological factors were investigated to assess relationship with the development of IH.Postoperative IH occurred in 29 cases (6.79% of all RARP patients), whereas 22 cases (75.9% of all IH patients) occurred within the first 2 years. The median follow-up period was 5.2 years, and the median age of patients was 65 years. Postoperative IH occurrence was significantly associated with body mass index (BMI), smoking history, and low surgeon experience (P = .036, .023, and .048, respectively). However, low surgeon experience did not reach statistical significance after multivariate analysis.The overall incidence of IH after RARP was significantly associated with BMI and smoking history. With obvious incidence of IH within the first 2 years after operation which was not observed at the open prostatectomy, RARP itself may play a role in the development of IH.

Nongenitourinary complications associated with robot-assisted laparoscopic and radical retropubic prostatectomy: A single institution assessment of 1,100 patients over 11 years

ObjectivesRobot-assisted laparoscopic prostatectomy (RALP) and radical retropubic prostatectomy (RRP) provide similar outcomes in terms of biochemical recurrence, postoperative continence, and erectile function. Little is known about other complications of these procedures. To further address this, we examined patient outcomes at our institution over an 11-year period. MethodsA retrospective review of 1,113 prostatectomies (646 RALP and 467 RRP) performed over 11 years by 9 different urologists at a single U.S. academic center was undertaken. Preoperative data collected included age, body mass index (BMI), prostate-specific antigen (PSA), biopsy Gleason score, and tumor (T) stage. Postoperative data included pelvic lymph node dissection (PLND), intensive care unit (ICU) admission rate, length of stay (LOS), ileus, wound infection rate, umbilical hernia occurrence, inguinal hernia occurrence, ophthalmic complications, upper and lower extremity complications, postoperative neuropathy, residual cancer, and cancer recurrence. ResultsSignificant differences between RRP and RALP included performance of PLND (54.1% vs. 35.9%, P < 0.0001 respectively), umbilical hernia rates (2.4% vs. 6.5%, P = 0.0015, respectively), inguinal hernia rates (5.4% vs. 2.5%, P = 0.0101, respectively), and LE complications (9.0% vs. 5.1%, P = 0.016, respectively). No difference was observed regarding ICU admission, LOS, ileus, wound infection, and ophthalmic or upper extremities complications. ConclusionsRRP patients were more likely to have lower extremity complications and inguinal herniae, whereas RALP patients had an increased umbilical hernia rate and a trend toward more corneal abrasions.

A second thought on low lying pubic tubercle -can inguinal hernia occurrence be predicted?

Introduction: Among all hernias inguinal hernia is known to be the most common condition for which surgery is being performed and 75% of all hernia occur in groin.The low pubic tubercle has more tendencies for herniation due to unusual origin of internal oblique muscle leaving internal ring unprotected during abdominal muscle contraction. In view of this we conducted a study to evaluate the incidence of inguinal hernia in low lying pubic tubercle and its correlation with occurrence of inguinal hernia.Materials and methods: A Hospital based prospective study was be conducted on 100 patients, who came with inguinal hernia conducted from May 2015 to April 2018 at Father Muller Medical College Hospital and those who met the criteria. Plain Anteroposterior Radiographs of Pelvic region in 100 patients of inguinal hernia and to find out if low lying pubic tubercle has any correlation with occurrence of inguinal herniaResults: A total of 100 patients with inguinal hernia meeting the inclusion criteria was included in the study, plain X-ray of the pelvis was taken to measure SS (Distance between each anterior superior iliac spines) and ST (Spinotubercular) line and we found that 76 patients out of 100 (76.0%) patients with inguinal hernia had a low lying PT that is ST &gt;7.5 cms. 78 patients had indirect inguinal hernia and 32 patients had direct inguinal hernia.In our study of groin hernias, the most common age group involved is the 41-50 years age group with 17 cases 42.5%. The mean age in our study was is 47.05 years Standard deviation of age is 12.15years. In our study of groin hernias, the most common gender involved in groin hernias was male with 38 cases 95% of the cases.

Inguinal Gravid Hysterocele in Feline

Background: Hysterocele is an inheritance rare in feline, characterized by the protrusion of the uterus by the inguinal channel, a situation related with the congenital abnormality of the inguinal ring, allowing the protrusion of abdominal contents for the subcutaneous space. As differential diagnosis of hysterocele are the breast cancer, abscesses and bruises and image exams such as radiography and ultrasonography have large relevance for identifying the disease and, additionally, clarify the hernia content. The purpose of this study was to describe one case report of the inguinal gravid hysterocele in a cat.Case: A 1-year-old female feline, without history of trauma of increase of volume in the inguinal region was referred for clinical evaluation. Due to the presence of three gestational vesicles, the decision by following-up the fetal development was taken, by means of periodical ultrasound evaluations, for performing operative procedure. At 56 days of gestation, when intestinal peristaltic movements of the three kittens were observed, cesarean was indicated. The procedure began by an oblique incision in the left retro-umbilical region, however, due to adhesions, there was no proper uterine exposition for hysterotomy. Retro-umbilical celiotomy, adhesiolise and return of the uterus for the abdominal cavity were performed in order to execute the cesarean followed by ovariohysterectomy. The hernial ring was debrided and sutured in order to keep patent the inguinal ring. No post-operatory complications were noted indicating that the established conduct allowed the survival of the parturient and its kittens.Discussion: In a casuistic study where data from 1988 until 2007 were collected, from the Faculty of Veterinary Medicine from the University of São Paulo, a higher occurrence of inguinal hernias was observed in female dogs, when compared with male dogs and, until that period, the inguinal hernia was not reported in the feline species. It is known that the inguinal ring may dilate with the obesity and increase of the intra-abdominal pressure, linked with the weakening of the adjacent structures. Besides, the appearance of hysterocele in females is also related with the estrus or gestation, caused by the hormonal imbalance, leading to the weakening of the conjunctive tissue, resulting in the enlargement of the inguinal rings, which is according to what was observed in this report where the animal was pregnant. Additionally, the application of contraceptive (progestin’s) could have accentuated the muscle fragility, favoring the projection of the uterus by the inguinal ring. In most of the cases described in literature, animals have no discomfort to the handling of the herniated content however, for some authors, the prolongation of surgical resolution may aggravate the clinical condition, predisposing the formation of adherences that may cause discomfort or pain, particularly when the bladder or intestinal loops are involved, resulting in difficulty urinating and defecating, respectively. Care must be taken during the reduction of the inguinal ring, in order to avoid compromising the external pudendal artery and vein, and of the genito-femoral nerve, which emerge from the tail-medial aspect of the ring. In this study, it was tried to perform the hernia suture in a way that the inguinal ring remained patent. On the same way that was performed in this study recommend the execution of ovariohysterectomy in order to avoid relapse and because it is an hereditary condition. The inguinal gravid hysterocele in feline may be adequately manage until the ideal moment for cesarean without prejudice to the parturient and to its products.

Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy

BackgroundRobot-assisted radical prostatectomy (RARP) has now become a gold standard approach in radical prostatectomy. The aim of this study was to investigate incidence and risk factors of inguinal hernia (IH) after RARP.MethodsThis study included 307 consecutive men who underwent RARP for the treatment of prostate cancer from January 2011 to August 2015. The incidence of IH after RARP was investigated. Clinical and pathological factors were also investigated to assess relationship with development of postoperative IH.ResultsMedian follow-ups were 380 days, and median age of patients was 67 years. Incidence of IH was 11.3, 14.0, and 15.4% at 1, 2, and 3 years after RARP, respectively. Postoperative IH occurrence was significantly associated with low surgeon experience and postoperative incontinence at 3 or 6 months after surgery (P = 0.019, P = 0.002, and P = 0.016, respectively).ConclusionsMost of the IH occurred within the first 2 years with a rate of 14%. Incidence of IH after RARP was significantly associated with surgical experience and incontinence outcomes.

Anatomical Retzius-space preservation is associated with lower incidence of postoperative inguinal hernia development after robot-assisted radical prostatectomy.

Postoperative inguinal hernia (IH) is a non-negligible sequelae with a wide array of rates after robot-assisted laparoscopic radical prostatectomy (RALP). Our aim was to evaluate the incidence and risk factors of postoperative IH development in men undergoing RALP. A retrospective analysis of 839 patients "541 of conventional-RALP (C-RALP), and 298 of Retzius sparing-RALP (RS-RALP)" received treatment of prostate cancer between 2005 and 2016 and met with our inclusion criteria was performed. Primary endpoint was incidence of IH after RALP, while secondary endpoint was to assess risk factors of IH occurrence. Overall incidence of postoperative IH was 6.3% (53 out of 839). Mean follow-up period and median time of IH development were 24.1 and 14.0months, respectively. Among patients who developed IH, there was a higher incidence in C-RALP compared to RS-RALP, (79.2 vs 20.8%, respectively, P=0.02). Multivariate analysis showed that BMI group (HR 0.471, P=0.023) and C-RALP (HR 2.834, P=0.002) were significant predictors of IH development. Kaplan-Meier curve showed that 3-year IH-disease progression free rate was significantly higher after RS-RALP compared to C-RALP (94.2 vs 71.6%, respectively, P<0.001), likewise in obese versus non-obese patients (87.7 vs 76.6%, respectively, P<0.003). Our study showed that overall incidence of IH was 6.3% after RALP. Nevertheless, RS-RALP carries a lower incidence of IH after surgery, while C-RALP and low BMI are predictors of IH development.

Prevalence and risk factors of inguinal hernia: a study in a semi-urban area in Rayalaseema, Andhra Pradesh, India

Background: The protrusion from the abdominal cavity through the inguinal canal is called inguinal hernia. Although several hypotheses regarding the etiology of inguinal hernia have been proposed, large-scale data on the occurrence of inguinal hernia may provide further understanding to the pathophysiology of inguinal hernia development. This study was conducted with the intention of identifying the various types of inguinal hernia observed in our area as well as their risk factors. Methods: All the study subjects had come to the hospital with complaints of groin swelling with or without pain. The patient was palpated at each groin to observe if there was a visible and clearly palpable hernia, a palpable impulse or a previous operational scar. Details of the hernia, such as the type of hernia, primary or recurrent were also noted. Results: Out of the 212 patients, 79.2% patients were males and 20.8% were females and the commonest age group was 31-60 years. 74.5% of the cases were primary inguinal hernia while 25.5% were recurrent hernia. Period of swelling was less than one year for majority of the patients, while the least of them had swelling for more than 2 years. The most common cause for the presence of hernia was lifting heavy objects in 52.4% and improper bowel movements (46.7%). Conclusions: These type of studies need to be conducted in every geographical area so that it can be helpful for future studies in prediction of the prevalence of inguinal hernias.

Новые данные по типовой и вариантной анатомии пахового промежутка

Relevance In a Herniology prediction problem of inguinal hernias is still actual. For many decades studying of prerequisites of emergence of inguinal hernias is conducted. However, not enough attention is drawn to the typical characteristics of a person and surgical anatomy of the anterior abdominal wall. The purpose of the study To study sexual, age and sample features of a structure of an inguinal gap. Materials and methods Work done on the 123 floating corpses of both sexes. Has been determined by body type, shape of the abdomen and the form of inguinal gap. Also measured the length of the inguinal gap, its angles, the thickness of the abdominal muscles. Performed histological examination of biopsy specimens of the internal oblique abdominal muscles. Results and their discussion Has been concretized the structure of inguinal gap depending on its shape. Noted that the frequency of the triangular shape of the inguinal gap over the last three decades has increased from 5.3 to 20.8 % for men and from 0% to 12.5% - women. Proved that with age inguinal gap increases, crescent aponeurosis narrows, and the thickness of the muscle decreases. In the structure of muscle fiber degeneration occurs, the disorganization of the extracellular matrix and venous stasis with perifocal edema. Studied typical features of the structure of inguinal gap. Determined that the triangular shape of the inguinal gap often observed at persons with brachymorphic body type. Oval-transitional form of inguinal gap was typical for persons with dolihomorphic and slotted-oval – for persons with mesomorphic body type. At the male shape of the abdomen all forms of inguinal gap observed equally often. At the persons with the female shape of the abdomen prevailed slotted-oval and oval forms of inguinal gap, the triangular shape was observed in only 8.3%. At the oval shape of the abdomen was noted in half of the cases oval - transitional form of inguinal gap. Conclusion Identify new patterns in the structure of the inguinal gap, which can be used in clinical practice for predicting the occurrence of inguinal hernias. Key words Inguinal gap, variant anatomy, body type, shape of the abdomen

Laparoscopic Observations in Acquired Inguinal Hernia before and after Robotic-Assisted Laparoscopic Prostatectomy

Background: The mechanism of the development of acquired inguinal hernia, especially indirect inguinal hernia, is not well known. Although anatomical studies have been performed to explain development of inguinal hernia, they have mainly involved autopsy or temporal findings at the time of hernioplasty. To elucidate the pattern of development of acquired inguinal hernia, we studied the occurrence of inguinal hernia after robotic-assisted laparoscopic prostatectomy (RALP). Methods: From March 2009 to November 2011, RALP for prostatic cancer was performed on 60 patients in our institute. The RALP was performed by one urologist using the da Vinci Surgical System. The postsurgical development of inguinal hernia was diagnosed based on patients’ symptoms. Seven patients were treated with laparoscopic hernioplasty, and one underwent mesh-plug repair. Using video recordings, the laparoscopic findings during RALP and laparoscopic hernioplasty were compared among all patients. Results: Seven of 59 patients (11.9%) developed an inguinal hernia. One patient had a pre-existing pantaloon inguinal hernia at the time of RALP. Eleven inguinal lesions in the seven patients who underwent laparoscopic hernioplasty were reviewed, and all were indirect inguinal hernias. Conclusion: A main factor in the development of inguinal hernia after RALP could be a combination of outer-side intact layers and inner-side hard scar of the inguinal ring, which seems like “out swing door”.

Use of an automatic stapling device during castration to prevent (re)occurrence of inguinal hernia in horses with large vaginal rings

Use of an automatic stapling device during castration to prevent (re)occurrence of inguinal hernia in horses with large vaginal rings

Ruptured Hemorrhagic Ovarian Cyst Presenting as an Incarcerated Inguinal Hernia in an Adult Female: A Rare Clinical Scenario of a Common Surgical Emergency

Embryoanatomical peculiarities are responsible for low occurrence of inguinal hernias in females. Amongst them, ovarian hernias are rarer. They are commonly noticed in children. An attending surgeon commonly faces diagnostic and operative dilemmas in managing these overtly “simple-looking” clinical scenarios. Although ovarian cysts are one of the common contents of the sac, we report a case of adult incarcerated ovarian hernia who presented with a ruptured hemorrhagic ovarian cyst. This differential should be kept in mind while treating an adult female with painful inguinal swelling. As far our knowledge goes, such case with ruptured ovarian cyst presenting as an incarcerated hernia in an emergency scenario has not been reported as yet.

Two cases of female hydrocele of the canal of nuck

The processus vaginalis within the inguinal canal forms the canal of Nuck, which is a homolog of the processus vaginalis in women. Incomplete obliteration of the processus vaginalis causes indirect inguinal hernia or hydrocele of the canal of Nuck, a very rare condition in women. Here, we report 2 cases of hydrocele of the canal of Nuck that were diagnosed with ultrasonography in both cases and magnetic resonance imaging in 1 case to confirm the sonographic diagnosis. High ligation and hydrocelectomy were conducted in both patients. In 1 patient, 14 months later, the occurrence of contralateral inguinal hernia was suspected, but did not require surgery. The other patient had a history of surgery for left inguinal hernia 11 months before the occurrence of right hydrocele of the canal of Nuck. In both cases, the occurrence of an inguinal hernia on the contralateral side was noted.